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2023 Wells Fargo Healthcare Conference

Sep 6, 2023

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Hi, everyone. Thanks for joining us. I'm the healthcare services analyst, Steve Baxter, here at Wells Fargo. We're really pleased to be joined by Oscar Health, an innovative health plan focused on the individual exchange market. From the company, we have Scott Blackley, the CFO. Thank you for being here today.

Scott Blackley
CFO, Oscar Health

Pleasure. Nice to be here.

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Yeah. So first, welcome back to the CFO seat. It's great to have you with us. Just give us a little sense of what brought you back to the CFO seat and how the time you kind of spent away with your other responsibilities is going to help you, you know, be the CFO of the company going forward.

Scott Blackley
CFO, Oscar Health

Yep. So for those not familiar with my personal journey, about just a little less than a year ago, I moved into a role in Oscar that we called the Chief Transformation Officer, which was overseeing the company's operations as well as our +Oscar technology business. I really did that because I was the CFO prior to that role, and it was obvious to me that, you know, to really drive where we needed to be as a business.

I wanted to get closer to the types of things where we needed to, you know, drive some action. Scroll forward, a year later, Mark Bertolini had joined us. We've added some additional executives, and we now have, you know, kind of the right leaders and bandwidth to, you know, take on those, those areas that I've been focused on.

In addition, feel like we've really delivered against the plans that we had to create kind of hardening our operations and getting technology, you know, really, you know, starting to come to market. We brought our +Oscar Campaign Builder to market, and, you know, just felt like it was a perfect time for me to move over into the CFO job.

Obviously, as a CFO, you always want to underwrite your decisions before you take on guidance. Just knowing that the company was in a really good place on delivering on our plan for 2023 and 2024 made it a no-brainer for me to jump back into the role.

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

That's great. Then it's been almost six months now since Mark was announced as the CEO. I mean, I'd love to hear from your perspective, a little bit of inside baseball on how Mark's changed things so far and kind of where you think, you know, how that changes the trajectory of the company.

Scott Blackley
CFO, Oscar Health

Mark is a really unique mixture of a guy who has all the experiences of running large, complex organizations, but also someone who thinks in just a strategically innovative way. So he is a perfect blend for Oscar, where we're trying to be innovative, but we're also trying to be a scale player.

The things that I've observed with Mark is that he just has such an incredible nose for where there's leverage in the business and the things that we can lean into to drive, you know, stronger performance, drive better member outcomes. So on that side, I think, you know, I've certainly seen Mark, you know, pretty quickly putting his eye to things that we need to improve on.

The other thing that I think Mark has done is to create kind of a operating routine at the company where we are more disciplined about, you know, making sure that we have targets for all the critical things that we need to deliver on, that we have strategic plans that we work backwards from. And, you know, so he's kind of putting his thumbprint on how should we run this company to be successful in the future and make sure that we deliver on our, you know, the execution that we've promised our investors.

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

That's great. And I saw even just today, you know, Mark and the team have announced a couple of, you know, very senior hires to work with Mark, people from his background. Just give us a sense of, you know, kind of where you guys stand in terms of the build-out of the leadership team at this point.

Scott Blackley
CFO, Oscar Health

Sure. So, we announced today, in fact, that we brought in two senior executives, Steve Kelmar, who most recently is at CVS, and Steve's going to be joining as Mark's Chief of Staff and Head of Strategy. And so he's a, you know, industry veteran who Mark's worked with previously. He will be helping us kind of... When I talked about Mark's management process, you know, Steve will be helping drive that management process and also helping us craft a strategy for the future.

And then we also announced Kerry Sain is joining as the Head of +Oscar. And so Kerry is a, you know, technology sales veteran who, you know, has worked at a number of organizations, you know, both small and large-scale SaaS players, but also, you know, running different components of healthcare growth operations. So she's deep in healthcare, but she's also, you know, kind of an experienced hand in driving sales and product development. So you know, we're incredibly excited to have her come in just as we're, you know, really starting to put our foot down on +Oscar.

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Great. Okay. And then, you know, to pivot a little bit, you know, utilization's obviously been a tremendous area of focus. You know, in the first half of the year, you know, the company's obviously posted very strong results in light of, you know, some utilization pressure elsewhere, seemingly in the marketplace.

I guess, just give us a sense of how utilization's trended for you guys. I guess, you know, I think you've mentioned, for example, that, you know, maybe you're seeing a little bit higher, like, prescription drug costs, and you're seeing a lot lower kind of professional expenses. Kind of what's the latest on utilization and how you guys are shaping up?

Scott Blackley
CFO, Oscar Health

You know, through kind of July, we've not really seen anything in the results that is different from what we talked about in the second quarter. Utilization has been, you know, right pretty much on plan for us, where we've seen. And we talked about some of the pharmacy drugs being a little bit higher, as you talked about, you know, some of the, the categories being a little bit lower.

But in general, when I step back from the individual puts and takes, I would say that utilization for us has been pretty consistent with what we expected, which gives us confidence about the rest of the year. We've not seen anything that, that has really popped out. The early read on some of our Medicaid redetermination members has been. This is a small population, let me be clear about that. But, you know, those members are performing slightly positive than what we had built into-

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Okay

Scott Blackley
CFO, Oscar Health

Our pricing expectations for 2023. We've not seen anything that, you know, suggests that there's a big bias there, that they're going to perform much worse than we expected.

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Yeah.

Scott Blackley
CFO, Oscar Health

We did expect them to perform, you know, slightly worse than the average of our members, but we're seeing the kind of performance that is, you know, again, slightly better than what we anticipated on a very small sample.

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Got it. Okay, and I was gonna ask, at this point, like, how much visibility do you think you actually, you know, have on, on these members? Like, do you think you'll be at a point in a couple months where you'll have greater certainty of that, or is it still-

Scott Blackley
CFO, Oscar Health

I think that we've seen kind of the redetermination in full swing. You know, we've seen a portion of that population coming through in SEP. You know, we're pretty pleased with what we've found so, you know, thus far, which gives us, you know, positive, you know, expectation about what we may see in 2024 when more-

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Mm-hmm

Scott Blackley
CFO, Oscar Health

... of those members come through in OE. And again, we built into our expectations, pricing them around performance of those members, and thus far, you know, feel like what we've seen gives us some confidence that, you know, those assumptions are pretty good.

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Got it. And I guess how would you characterize what you're seeing on the actual membership side? I think you didn't really see a ton of impact, maybe initially in Q2, just given the timing, and I think, like, the Florida-

Scott Blackley
CFO, Oscar Health

Right

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

-enrollment cap was still in place. I guess now that there's more full swing and Florida's kind of back in the mix-

Scott Blackley
CFO, Oscar Health

Yeah

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

... what are you seeing there?

Scott Blackley
CFO, Oscar Health

You know, I don't have an update for you, you know, post-Q2 beyond to say that we, you know, we started taking new members in Florida post the enrollment cap and, you know, are again moving along and we've given guidance on revenues for the year and confirmed that guidance and feel like we're on track to deliver.

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Okay. I guess, what's your initial sense of how, as you look out to 2024, you know, competitive dynamics are, are shaping up for the exchanges? Obviously, been a lot of moving pieces with players kind of coming in and out of the market. It feels like maybe some of the, the nationals maybe were a little over their skis on, on pricing this year and are going to have to fix that. I guess, how do you think about all these puts and takes for, for next year?

Scott Blackley
CFO, Oscar Health

Yeah. So 2024 pricing, pretty much done at this point.

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Yeah.

Scott Blackley
CFO, Oscar Health

And I think that from Oscar's side, our pricing strategy was, you know, kind of twofold. We wanted to return to growth.

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Mm-hmm.

Scott Blackley
CFO, Oscar Health

We saw a market that was expanding, and we wanted to make sure that we got our share of that expansion. So we priced for growth, and we priced for margin. So we think that we've got a pretty strong competitive position. I think that I've obviously read your research and, you know, you've said much the same, that we're slightly below the national average on our pricing. So, you know, pricing is an incredibly market-by-market dynamic, right?

And so when I look at our, at the competitor mix of pricing, I think we are well-positioned to achieve growth that is at or above the market. And, you know, we think that the ACA market's probably gonna grow something like 15%-20% for 2024. We think we'll be able to grow at or above that in terms of, you know, what we realize to growth in our revenue.

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Got it. Okay, so that makes sense then. So if you're thinking the market grows 15%-20% potentially, and then you guys, I think, have talked about, you know, a 10 expansion into more, like, rural service areas in some of your existing markets, and that I can't remember if you quantified the magnitude of it, but that's kind of how you get to that attractive level of growth without having to really create too much of a trade-off on the market side.

Scott Blackley
CFO, Oscar Health

That's right. And so with the market growing overall, and I think a pretty rational competitive pricing environment this year- we see opportunities from service area expansion. You talked about the fact that we've, you know, we've really-- we're, we expect to grow in footprint, and we're, we're expanding into adjacent communities. We call that, you know, rural. I would say those are, you know, adjacent to urban areas.

Part of that strategy is to ride the back of existing provider relationships and provider networks, so, you know, they're contracts we know well, they're providers we know well. That, we think that gives us a good, you know, ability to predict, you know, the performance of how those networks will work. I think that the combination of that rural strategy, which I think our TAM final pricing, is probably something like 500,000-600,000 new lives-

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Mm-hmm

Scott Blackley
CFO, Oscar Health

... for us. And, you know, when I look at the combination of the expansion plus the market growth, plus our price position, I think that positions us pretty well to grow, you know, as we've talked about in the high teens to the twenties.

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Okay. No, that's great. And then, you know, as you guys think about, you know, 2024, it's a little harder for us to parse out, like, what the, I guess, the non-Medicaid redeterminations growth is inside of that figure. I guess when you think about the long-term growth potential of the exchanges, you know, what, what do you think are the key levers to consider?

I mean, obviously there's just the growth of the overall U.S. population, further reductions in the uninsured population, and then transitions, I guess, potentially out of small group coverage as it relates to ICHRA. I guess, how are you guys thinking about, you know, what a potential sustainable long-term membership growth could look like for the industry at this point?

Scott Blackley
CFO, Oscar Health

You know, I think that's a really dynamic question, and I would say that, I think we would all agree that the existential risk of the ACA going away is probably behind us.... I think that we will see, you know, the ACA will continue to be a political topic, though, and, you know, it's hard to predict exactly where that's going to land. And I think the biggest, you know, set of issues there could be what happens to the enhanced subsidies that we're-

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Mm-hmm.

Scott Blackley
CFO, Oscar Health

Currently, you know, enjoying as an ACA competitor. And, you know, for me, when I just step back and say: What's the future of the ACA? It certainly proved to be one of the more competitive priced marketplaces, which I think is good for, you know, the, the industry overall and for the ACA participants.

You know, that's a really good thing. We think that individualization is a, an important development in insurance, and it's happening in the ACA. We think we're a leader in supporting kind of, you know, high-touch member services, and we think we have the ability to win there, you know, where the ACA grows. It just strikes me that we're at full employment.

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Mm-hmm.

Scott Blackley
CFO, Oscar Health

It's unlikely we're going to see, you know, employment at consistently lower levels than where we are. That's gonna go, you know, goes well for the ACA. You know, if we think about economic dynamics and, you know, are we likely to see more people coming into the ACA, whether that's through, you know, immigration or otherwise, I just think that the market has proven to be durable, and that people will find a way to get into the ACA, whether it's through brokers or through the exchanges. It's a product that's got traction, and it's hard to see it going away.

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

One of the big initiatives that the company has undertaken is the BPO recontracting. I think that the savings were previously sized somewhere in the kind of nine-figure range, which is a pretty wide and unspecific range. I was wondering if you might wanna update us a little bit. If there's any precision you can lend to the nine-figure number, obviously we would take that.

But I guess in the absence of that, how should we think about the cadence of whether, you know, much of that savings was realized in 2023, and how much of it remains available to support the company's financial objectives for, you know, for 2024 and beyond?

Scott Blackley
CFO, Oscar Health

Yeah. So we signed a new PBM contract this year that gave us, you know, a 3-year contract from 2024 through 2026, so the terms of the existing contract. That also came with, you know, some 2023 advantages that we were able to get through that renegotiation.

It has always been part of the vision of Oscar that as we got to scale, we would be able to get more benefits, like this PBM, so this, you know, really is consistent with what we were anticipating for the company. But I would just say that 2023, you're seeing a, you know, a reasonable but a relatively, you know, modest-sized benefit in the current period. Next year, that benefit goes up, you know, significant from the 2023 levels.

So part of the drivers of, you know, we think that we're going to be profitable as a total company next year, the PBM benefit will certainly help us there. And, you know, we think that there's more to come on that PBM contract, so-

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Mm-hmm

Scott Blackley
CFO, Oscar Health

... the way that that arrangement is structured, the benefits increase each year during the duration of the contract. So it's not like we hit a steady state in 2024. We'll actually see more benefits, more benefits each year during the term of that contract.

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Okay. And then, you know, another large opportunity that, you know, the company spent more time talking about recently is kind of like payment integrity or waste, fraud, and abuse. And I think some of the statistics out there was that at the industry level, something like a couple hundred basis points of claims are typically, you know, rejected and not paid.

And for Oscar, I think that level was significantly lower. You know, where does the company stand in terms of, like, standing up the workflows that would be needed to, you know, to maybe get closer to an industry level of performance there? And again, also, like, what is the expected cadence of when you might be able to fully see the benefits that you're targeting?

Scott Blackley
CFO, Oscar Health

One of the things that I did when I was in the Chief Transformation Officer role was to spend time on-

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Yeah

Scott Blackley
CFO, Oscar Health

... time on these kinds of things, where I would say that Oscar has been, over our tenure, you know, now 11, 12-year life, really focused on the member experience.

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Mm-hmm.

Scott Blackley
CFO, Oscar Health

We have good back-end functionality and tools, but we haven't optimized those.

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Yeah.

Scott Blackley
CFO, Oscar Health

One of the things that Mark, you know, pretty quickly was able to do is to put his finger on, like, "There's buckets here, here, here." He's kinda, you know, he's described those as watermelons on the floor.

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Yes.

Scott Blackley
CFO, Oscar Health

and, you know, so for example, fraud, waste, and abuse. We have processes where we use third-party vendors that do seco nd pass reviews on claims, but there is more that we can do there. We, you know, we think there's an opportunity to bring AI to bear on that use case. That's a pretty, you know, rich area for AI to work. But for us, I think we—I would describe it as in 2023, we enhanced our reviews around fraud, waste, and abuse, so we're- seeing some of that benefit this year.

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Yeah.

Scott Blackley
CFO, Oscar Health

The full-year benefit will be in 2024, and we're stepping up that activity. So, you know, I would anticipate that when we again talk about why we're going to be delivering full company profits in 2024, part of that is gonna be on the back of-

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Mm-hmm

Scott Blackley
CFO, Oscar Health

... you know, these operational enhancements that really get us to, you know... I don't think we're gonna get all the way to that, the levels that are possible, but we're certainly gonna take some big steps in that direction.

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Got it. And do you feel like there, there are key risks that you need to manage as you do that? Like, whether it comes down to, to member or provider satisfaction, or is the point of view that if, if the underlying activity is truly waste, fraud, and abuse, that, like, none of that, none of that should really matter?

Scott Blackley
CFO, Oscar Health

I think that there are those things that are truly fraud, right? That's a no-brainer.

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Yeah.

Scott Blackley
CFO, Oscar Health

... take those off. You know, when you get into abuse and waste, those get to be subjective. So our, the processes that we would do have a lot of identification of potential-

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Mm-hmm.

Scott Blackley
CFO, Oscar Health

areas, and that's kind of an algorithmic, that's where AI can be brought to bear, of identifying those things that are on the edge.

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Yeah.

Scott Blackley
CFO, Oscar Health

You look for patterns and, you know, then we've got kind of, people who then look at those cases to see what is this, and how does it impact the member, how does that impact the provider? Because it can create friction, there's no doubt.

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Yeah. Mm-hmm.

Scott Blackley
CFO, Oscar Health

And so we wanna do it in a way that is both member-centric and, you know, doesn't create adverse outcomes with providers where they shouldn't.

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Mm-hmm.

Scott Blackley
CFO, Oscar Health

And so I would say we're super sensitive to that, and we have a pretty... process that's both automated, but then has lots of manual review to make sure that we, you know, we take close care...

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Okay

Scott Blackley
CFO, Oscar Health

around those topics.

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Got it, and then, you know, the third key lever kind of feels like it is just continued SG&A leverage, and I guess that gets a little bit easier to visualize or conceptualize as the company returns to, to growth next year. I guess, help us out with, you know, beyond just the, the fixed cost leverage of growing the business, like, where does the company see opportunities to, to make further progress-

Scott Blackley
CFO, Oscar Health

Yeah

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

-on cost structure?

Scott Blackley
CFO, Oscar Health

So going into 2024, one of the things that I'm really excited about is that we, in 2023, we invested in, you know, a lot of the technology that we use in our concierge functions. These are our call center people, you know, skilled professionals that are interacting with our members as well as providers. And, you know, we, we increased the ability for self-service in those queues. We expanded the use of BPO services, where we can scale using-

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Yeah

Scott Blackley
CFO, Oscar Health

you know, third parties, and so we are going to be a much more efficient. If you think about growth, you know, when we were growing really quickly in 2022, we had to really ramp up our infrastructure-

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Mm-hmm

Scott Blackley
CFO, Oscar Health

to support that growth. With, you know, some of the technology investments we made in 2023, we will be able to grow in 2024 with a much lower ramp than what we've seen historically. So that's an example of the kind of thing where, the technology investments that we've made in this year, where we've had a, you know, kind of a calm period of growth, we're now going to be able to grow at a much more efficient variable cost.

So I'm excited about that. And then, just beyond that, I think there's, there's additional, you know, kind of hardening of our infrastructure, where whether it's, you know, claims flows, how things work, where we've just put more eyes and brought in more, you know, kind of industry expertise to make sure that in all those queues, we're, you know, we're just getting more efficient at it.

I think it just represents the maturity of the company, and this is an area where Mark is, you know, kind of the now overseeing operations directly, is going to continue to drive us to just harden what we're doing, become better, leverage the technology, and really, you know, make us the most efficient insurance company we can be.

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Got it, and then, you know, I think that helps give a lot of context on, like, the levers you'll pull to deliver on 2024 targets. But I guess big picture, as we think about, you know, kind of the key swing factors of getting, you know, from this year's financial results to the financial results the company targets in 2024, is there anything else we should be thinking about? I guess, how would you describe that?

Scott Blackley
CFO, Oscar Health

Well, I'd start off by saying, you know, we've got a pretty good running start in 2023. Right? We, last quarter, talked about the fact that our insurance company, which we had guided, was going to be profitable, you know, from around $20 million to $120 million. We updated that guidance to tell the market that we would be at the high end of that range, and so we expect the insurance company to be, you know, have a healthy amount of profitability in 2023. That's a tailwind to next year.

When we think about the total company, we've got the PBM relationship that will see a bigger benefit next year. We've got administrative, you know, savings that I just talked about in terms of our ability to scale up and variable cost, as well as the fixed cost leverage-

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Mm-hmm

Scott Blackley
CFO, Oscar Health

-that you've mentioned. So lots of the bone structure that we need to be profitable is already in place, so that's, that's, why we feel, you know, pretty confident that we can deliver on that. I think that the things that we just, we need to focus on is truly just execution.

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Mm-hmm.

Scott Blackley
CFO, Oscar Health

And then, you know, as long as there's not some unexpected adverse development, a spike in COVID, something that, you know, comes out of the blue, you know, we feel like we are really well positioned to deliver.

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Okay. Then pivoting a little bit to the +Oscar side of the business, you know, obviously there's been a bit of a transition there in terms of, you know, maybe the, the current products that you have in the market, also kind of the near-term strategy. I guess, what's the latest on +Oscar?

Scott Blackley
CFO, Oscar Health

Yeah

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

How things are going as you've kind of continued to roll out Campaign Builder more broadly?

Scott Blackley
CFO, Oscar Health

So one of the most fun things that I did over the last year was to spend a lot of time on +Oscar-

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Yeah

Scott Blackley
CFO, Oscar Health

... including going out and visiting, you know, many prospective clients, whether those are health plans or providers. And, you know, the thing that I am certain of is that we have unique technology.

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Mm-hmm.

Scott Blackley
CFO, Oscar Health

It's unique because it was built for purpose, it's cloud native, and a lot of these terms get thrown around by, you know, lots of different people. So I know that it's hard to see the forest for the trees when it comes to technology, but our tech was built on modern infrastructure. It was built to be interoperable. It leverages one common data environment, and it is really designed to leverage AI to be efficient... and it's, you know, incredibly fungible.

And when I go out and I talk to others about, you know, what are your technology problems, it is the exact opposite of what we experience at Oscar. It's: My technology won't do this, my data—I can't get data to move from this system to that system.

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Mm-hmm.

Scott Blackley
CFO, Oscar Health

You know, I have no way of engaging my members. I have no tools. My call center people can't see what's in the claim system. All of that happens in our tech environments. So it just gave me an incredible sense of promise about what our technology, you know-

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Mm-hmm

Scott Blackley
CFO, Oscar Health

... what we can do with that in taking it to the market. We started with Campaign Builder this year-

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Yeah

Scott Blackley
CFO, Oscar Health

... which is an internal tool that we use to manage the work that we do in the company. So it is kind of a very user-friendly way of creating workflows in your system. You don't have to... You know, it triggers actions in systems, but you don't have to go into those systems and change the coding of them.

This tool allows us to configure. You know, it sends out, you know, calls to systems of, "Hey, if you're in the call center, call this member, do this action." We've been using that internally as the primary way that we shape our member and often provider-

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Mm-hmm

Scott Blackley
CFO, Oscar Health

... you know, communications and campaigns. And we're now taking all of that internal, you know, experience and making that available to third parties. And so we've had, you know, good success thus far in deploying that in our first two clients. We're excited about the future there. But if I just step back from +Oscar, I would say that having Kerry on board, who-

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Mm-hmm

Scott Blackley
CFO, Oscar Health

... I've been spending a lot of time with her over the last several weeks as we've transitioned. You know, she's got a really strong history of building strong products, strong sales and marketing teams.

So, you know, I think that the question for us on +Oscar, you know, is just about which things do we bring to the market, in what order? You know, how do we create SaaS? Most of the costs of, you know, the development of the products are already in the company. We already have the technologists in the company.

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Mm-hmm.

Scott Blackley
CFO, Oscar Health

So, you know, do we need to make some incremental investment in sales infrastructure, in some, you know, user experience front ends to these systems? You know, there will be some incremental investment, but I think the vast majority of it, it's already kinda happened, and we have the technology team in place that, you know, can work on bringing more SaaS versions of our products to market.

So I'm just incredibly excited about the potential for that, and it's just a question of cadence and how we bring those things to market. But, it's certainly an area of the company where we think, you know, there's a bit of a free option right now on the upside-

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Mm-hmm

Scott Blackley
CFO, Oscar Health

... from +Oscar just isn't in the valuation of the stock, and we think it's a good driver that's gonna help us outperform.

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Got it. And I think most people probably understand, you know, the use case for health plans in particular 'cause it's so analogous to how you operate today. When we think about the use case for providers, can you help us understand the pitch there a little bit better? And then just as we think about the revenue model, you said that it exists for Campaign Builder today. Just give us a flavor of-

Scott Blackley
CFO, Oscar Health

Yeah

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

... how that works.

Scott Blackley
CFO, Oscar Health

So actually, Campaign Builder, our first two deployments, are with, with-

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Mm

Scott Blackley
CFO, Oscar Health

... with providers.

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Yeah.

Scott Blackley
CFO, Oscar Health

And so we are using Campaign Builder. On the provider side, oftentimes, they don't necessarily have the technological ability to interact with their patients-

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Mm-hmm

Scott Blackley
CFO, Oscar Health

... in a way that, the Campaign Builder allows you to do, right? So we're helping them in closing care gaps, in driving, you know, visits to your PCP for-

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Mm-hmm

Scott Blackley
CFO, Oscar Health

... you know, getting your annual health screens. So we think there's that kind of functionality.

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Yeah.

Scott Blackley
CFO, Oscar Health

You know, we've talked a little bit about the fact that we think there's an opportunity for some health systems that don't have a health plan, that we could, you know, kind of bring Oscar in a box to them-

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Mm-hmm

Scott Blackley
CFO, Oscar Health

... and help them stand up and make plans where they can get a bigger share of the overall, you know, wallet from what's going on in healthcare. And, you know, we've done that in some configurations already, but we think there's more opportunity there. So, you know, when I think about Campaign Builder specifically, Campaign Builder basically is the way that that product works: You pay a price for a tier of campaigns.

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Okay.

Scott Blackley
CFO, Oscar Health

And, the more campaigns you wanna take from us, you know, you hit different price tiers. And we have a bunch of campaigns that we have built for our own use that, you know, we can make available to you, to our customers. And what we think is going to happen with Campaign Builder is, when you see success in running, you know, the first-

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Mm

Scott Blackley
CFO, Oscar Health

... you know, several campaigns, you're gonna want more of them, and so that's gonna be, you know, a revenue enhancement. But it's a high-margin business. That's the thing I love about it, is that even though, you know, currently, you know, we're talking about revenue in the $1-$9 million range from Campaign Builder, you know, it's, it's off of a base of zero, so we've got, you know, good growth there.

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Yeah.

Scott Blackley
CFO, Oscar Health

We see good prospects, and we see margin profile that's, you know, kinda similar to what you would expect for a, you know, pretty hands-on type of technology service. So, you know, let's say that those margins are in the 40-ish range and above, and the more things we do in +Oscar, you know, I think the margin profile can be above that. So adding that to an insurance company where, you know, we've got target margins in insurance at, you know, 5%+, you know-

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Mm

Scott Blackley
CFO, Oscar Health

... that gives us the ability to really drive the performance, kind of in the combined businesses, in a meaningful way.

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

... No, that's great. Then another thing that's been touched on, you know, over time is potentially, you know, within sort of the health plan side, specifically broadening focus a little bit beyond the individual exchanges. I think Mark has, you know, seemingly pointed to MA as an area where you think Oscar could make, you know, a bit of a, an impact over time.

I guess, as you guys have, you know, maybe it's too early to say for sure, but the company does have some exposure to MA today. How would the strategy potentially evolve to be different than it exists today for MA?

Scott Blackley
CFO, Oscar Health

Yeah, I think it is too early for me to say what, you know, how we will engage with MA.

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Yeah.

Scott Blackley
CFO, Oscar Health

I think it is, it is bringing Steve Kelmar in to help lead strategy-

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Mm-hmm.

Scott Blackley
CFO, Oscar Health

is going to be, you know, one of the things that Steve's gonna focus on, is how should we engage in this, this part of the business? I would just say that Mark's been pretty clear that, you know, Oscar has too many capabilities and assets to only bring those to bear on the ACA marketplace.

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Yeah.

Scott Blackley
CFO, Oscar Health

So over time, we're gonna be in more markets. And, you know, I think that how we do MA, whether it's only through +Oscar or through, it's also, you know, some risk-taking, I think we'll see how that plays out.

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Okay. And then, you know, just, it'd be great to get a sense of as you move towards, you know, adjusted EBITDA profitability for your total company next year. I guess, how should we think about, you know, the company's transition to cash flow positivity? And then just as a related question, just give us a sense of, you know, kind of where the company stands.

Like, obviously, like $250 million of parent cash at the moment. How much incremental capital should we think about as being, you know, available to you in subsidiaries? So overly capitalized subsidiaries, any other access to liquidity the company has-

Scott Blackley
CFO, Oscar Health

Right.

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

to kind of a broader picture of the liquidity profile of the company.

Scott Blackley
CFO, Oscar Health

So I've started the bottom and worked my way up. So, you know, the, we've got around $290 million of excess capital-

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Mm-hmm.

Scott Blackley
CFO, Oscar Health

at the insurance subsidiaries, and that's excess over our own internal thresholds.

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Okay.

Scott Blackley
CFO, Oscar Health

That is capital that we can use to fund growth. Historically, parent cash, the biggest use of parent cash, was to fund growth and operating losses at the insurance subsidiaries. So getting the insurance companies to profitability will allow us to have a considerably lower drag on parent cash.

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Mm-hmm.

Scott Blackley
CFO, Oscar Health

And, start with that building block. Then, when I look at the prospects of getting the total company to profitability in 2024, you know, we believe that our current cash position is sufficient, where we will be able to get. You know, that cash will take us out through full company profitability.

And so, you know, we feel like we're in a really strong liquidity position. Feel like we've got, you know, both the ability to generate excess capital at those subs, and over time, as those insurance subsidiaries have a history of being profitable, we can start to, you know, move some of the excess capital up to the parent and deploy that against, you know, our own, whatever choices we wanna make at the parent level.

And then, you know, the other thing that we just need to see is, you know, I talked about +Oscar as being a free option.

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Yeah.

Scott Blackley
CFO, Oscar Health

If the insurance company is covering the total cost of the company-

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Mm-hmm.

Scott Blackley
CFO, Oscar Health

through its earnings, then any incremental revenue, and, you know, we talked about the fact that +Oscar is gonna have a strong margin profile. Whatever we can bring to bear from +Oscar, most of the costs of that business are already in our run rate.

So everything that we do to generate +Oscar revenue with a high margin is just going to add to the financial strength of the company. And so, you know, kind of the combination of all those things make us feel pretty good about where we sit today.

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Okay, I think that's a great place to leave it.

Scott Blackley
CFO, Oscar Health

Great.

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Thanks so much for your time today.

Scott Blackley
CFO, Oscar Health

Appreciate it.

Steve Baxter
Senior Equity Research Analyst, Wells Fargo

Nice to be here.

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